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Subtle cues help obese shoppers skip unhealthy choices

La Azteca Market is a typical example of masmall markets in South Los Angeles, with junk food near the front door and checkout counter, seen Friday, Aug. 22, 2008. In the poorest parts of Los Angeles, a grocery store or a sit-down restaurant can be hard to come by, a reality local officials fault for the higher rates of obesity, diabetes and other health problems that plague the area disproportionately. Photo: Associated Press/Reed Saxon

By Anne Harding

NEW YORK (Reuters Health) – Subtle hints may help nudge people toward making healthier food choices at the grocery store, new findings suggest.

Obese people heading into a store who were given a recipe flyer with a few health-related words spent less than one-third the amount on unhealthy snacks as those given the same flyer with unrelated wording, Dutch researchers found. And the flyer had an effect even if people weren’t thinking about it as they shopped.

Laboratory studies have shown such “priming” with subtle messages can change behavior, and the current findings demonstrate that strategy can work in the real world, one of the study’s authors told Reuters Health.

“Subtle cues can have a strong impact on our behavior, without us noticing. Fortunately, this is true not only for tempting food that surrounds us and makes self-control difficult – it also works for subtle cues that remind us of our health and dieting goals,” Esther K. Papies of Utrecht University in The Netherlands told Reuters Health in an email.

“Little diet reminders can make it much easier to resist food temptations in stores, restaurants, and most likely also at home.”

People are “bombarded” everywhere with cues encouraging them to eat unhealthy foods, Papies noted. “People are getting a lot of money to prime us in this way,” she added. “These primes constantly activate the short-term goal of enjoying tasty food.”

To see if health-focused cues might help people make healthier choices, she and her colleagues designed two versions of a recipe flyer. One included words such as “healthy” and “good for your figure” and noted the calorie content of the dish; the other had non-health-related wording such as, “try it out” and “new recipe.”

The researchers handed the flyers out to shoppers on their way into a grocery store, and then looked at the shoppers’ receipts to see what they’d bought. Ninety-nine shoppers, including 42 overweight and obese people and 57 normal-weight people, participated.

Overweight participants who received the health-prime flyer spent about $1.40 on unhealthy snacks, including cookies, candy and chips, while those given the comparison flyer spent about $4.80.

However, there was no difference in the amount of money normal-weight people spent on those snacks based on which flyer they received, the study team wrote in the International Journal of Obesity.

Thirty of the study participants said they paid no attention at all to the flyer, and there was no association for these individuals between which flyer they received and how much they spent on snacks. But for overweight people who did pay some attention when given the flyer, receiving the health prime reduced their snack spending regardless of whether they reported thinking about the flyer as they shopped.

“The main issue is that the prime should be noticed, but it should not be a threatening health message,” Papies said – which is why phrases like “a healthy weight” are helpful.

Primes should not be “patronizing,” she added, because that can make people feel as if they’re being told what to do. “I would recommend nice-looking, health-positive posters at critical points in the store, and these locations could be varied, to prevent habituation; and for the shopper, I would recommend such cues on the grocery list,” she said.

Ideally, she said, policies would also help reduce junk-food primes by making those foods less available and restricting advertising to children, for example.

“However, in the meantime, consumers can protect themselves by implementing reminders of their personal goals,” Papies said. Such strategies include not buying junk food to keep at home and packing a healthy lunch for work and school.

“This is exciting news indeed,” John Bargh, a psychologist at Yale University in New Haven, Connecticut, told Reuters Health. He studies how non-conscious and automatic factors influence behavior, but did not take part in the new research.

Although some cognitive psychologists have questioned whether primes work to change behavior in the real world, “the best response is to show that these effects make a difference in people’s lives,” which the current study does, Bargh said.

“We definitely need more research showing real world applications of priming such as this new Papies study,” he said.